Binding globulins...

[AKatieD]

Anyone got a good handle on these, please?

The reason I ask is that I have had 3 months of increasingly debilitating fatigue. I take T3 only and was on 100mcg, which took me 70% through the range, I have also tried 125mcg which takes me well over the top, but still tiredddddd.

I have tested cortisol in blood at 8am recently which comes out lowish (206nmol/L on range 166 - 507), whereas 24 hr saliva cortisol is over the top of the scale across the whole day. Serum is total and saliva is free, so my guess is that this means the Cortisol Binding Globulin is not taking the free cortisol out of circulation and transporting it around the body? DHEA was very low at 0.01 (0.05-0.32).

4 years ago I did similar saliva tests and cortisol and DHEA at that time were low ( before started HRT).

I started testosterone as part of my HRT 8 months ago and a bit of research suggests T might affect CBG so perhaps this is the cause of low bound cortisol when there seems plenty of free.

Apparently there are links between the effect of T on CBG and Thyroid BG so then I am wondering if even though I seem to have plenty of T3 whether that is not getting circulated properly. I guess either low bound thyoid or cortisol could be causing the fatigue?

I am testing knocking out T for 2 days to reduce levels to see if this has an effect.

Anyone have any understanding on this?

[TiggerMe Ambassador]

Why not add some DHEA as you know it is low? They refer to DHEA as the 'youth hormone'

Over the past 18 months I've boosted everything that showed up as low and have reaped the benefits 😀

[helvella in reply to TiggerMe]

Because there are issues in getting hold of DHEA in the United Kingdom?

helvella - DHEA (Dehydroepiandrosterone) and UK Law

Information about UK law and DHEA (Dehydroepiandrosterone).

helvella.blogspot.com/p/hel...

[TiggerMe Ambassador in reply to helvella]

Doesn't seem to be a problem if you have a private Endo 🤷‍♀️ or self source...

[helvella in reply to TiggerMe]

You have to be able to afford a private endo. And many can't.

[TiggerMe Ambassador in reply to helvella]

I was assuming the OP is under and Endo being T3 only... luckily it is very cheap to purchase much like T3

[FallingInReverse in reply to TiggerMe]

Plus there’s lots of peeps here in the US… with low DHEA… so tigger definitely helpful reading your reply.

I am still optimizing my Ts, but have low DHEA. I keep reading your and Fancypants (?) posts and am queuing myself up to tackle sex hormones. Haven’t made the leap yet.

[TiggerMe Ambassador in reply to helvella]

My computer seems to be playing up as I keep getting and error code 504...can't access your link but it does show as dhae in the title 😉

[humanbean in reply to TiggerMe]

I'm getting error codes too. It must be yet another bug.

[TiggerMe Ambassador in reply to humanbean]

That's good to know, I did a reboot but still acting weird

[TiggerMe Ambassador in reply to helvella]

...

[helvella in reply to TiggerMe]

There are ridiculous problems changing links for pages on the blogger system.

It should have been working even if the link name was funny. Now I think fixed:

helvella.blogspot.com/p/hel...

[QUE6T-33]

Hi AKatie, interesting subject. Wasn’t aware of the Testosterone link. So you have high levels Free T3 & low Total T3 & likewise Cortisol. But it’s the Free hormones that are utilised @ cellar level, lack of those would certainly mean fatigue.. Some years ago now, but I had similar thought about possibility of having low level of CBG in relation to a 24 hr urine test result compared to bloods. He said it was a possibility, but that it was difficult to test for.

[AKatieD in reply to QUE6T-33]

Hi Que6t-33. No, I only know the free and bound status for cortisol and I am surmising the same for T3 (based on good free T3 levels and as I have read that T has similar effect on CBG and TBG). I am trying to work out why having a lot of free hormones when combined with low total, for cortisol at least, might cause fatigue and all I can come up with is the effect of binding globulins.

[AKatieD]

Thanks for the idea about DHEA. I self source, no endo, so would have to try to source it overseas.

Dr Myhill website suggests pregnenolone instead of DHEA, which you can get OTC here. Not sure of the benefits of one or other?

Helvella is that legal bit saying we can import medicinal products that contain DHEA if for personal use? I guess whether you risk it is another question.

Thanks both for the info.

[TiggerMe Ambassador in reply to AKatieD]

I've not had any issue getting it from...

uk.iherb.com/pr/davinci-lab...

I started on just DHEA which raised my levels up and for the last couple of months I've been alternating daily with the two.... along side all the other HRT 🙂

Seems to have help shake off the awful fatigue

[TiggerMe Ambassador in reply to TiggerMe]

Ideal ratio

My DHEA is now a little higher than ideal hence a slight change in tack, hoping my cortisol will pick up as still pretty low (both started off low but correct ratio)

[helvella in reply to AKatieD]

I found it very difficult to be sure what the legal bit says. Clearly, DHEA is a controlled drug. But the rest of the words are confusing!

[AKatieD]

Thanks for the update TiggerMe. Someone on eBay is selling too with a big mark up, presumably by importing from iHerb.

When you say alternating between the two - DHEA and what else (pregnenolone?)?

I see you are using quite a low dose (10mg?) by a manufacturer I have not heard about before. Was that a chance selection or is there something about that one you preferred compared to Pure Encapsulations or Swansons in iHerb, say? Was it the micronization?

[TiggerMe Ambassador in reply to AKatieD]

Sorry, I don't get an alert unless you use the reply button

I always research thoroughly and then purchase (often forget half the reasoning but it way sound at the time!) I choose the micronized one as it is better absorbed and has increased brain uptake (I'm thinking 3 x better absorption than non micronized) I prefer lower doses that can always be increased and yes I have some Swanson 10mg pregnenolone as it was the lowest they had

[TiggerMe Ambassador in reply to TiggerMe]

I did originally start with Life Extensions 15mg and swapped to micronized

[AKatieD in reply to TiggerMe]

Have you tried it vaginally as study said less likely to be converted to DHEA -S or testosterone. Not sure if that is a good idea or not?

[TiggerMe Ambassador in reply to AKatieD]

No not heard that, but micronised is also less likely to convert to those, remembering back I did lower my oestrogen and testosterone transdermals a little when using non micronized but put them back up when I swapped

[Incoguto]

There is a study that show that low DHEA is linked to being hypo.Do you split your t3? Also, did you have bad effects when taking t4? Sometimes t3 cannot fill the gap that t4 has left. My own personal theory.

[AKatieD]

Yes, I split the t3. When I moved from NDT I did try adding a bit of T4 but it did not seem to have any effect so I gave up. How much would you think worth adding if I tried again?

[Incoguto in reply to AKatieD]

It is hard to say. Have you ever tried taking t3 in one go?

As for t4, I'd always go low and slow. But maybe it is before to tweak t3 before you go that way

[AKatieD in reply to Incoguto]

Thanks again for the info. No, not tried that, I have been trying a 4am dose as per CT3M but no obvious impact on fatigue. When do you take your one dose and how did you stage it - or did you just move all at once?

[Incoguto in reply to AKatieD]

I just moved to all at once.I was just reading that testosterone lowers TBG.

"Androgens lower TBG levels. Some men treated with testosterone require a slight lowering of their thyroid hormone dosage while those who discontinue testosterone may need to increase the dose."

I've been applying T cream for the past 3 weeks, I am not really feeling anything different, but my skin is oily (could be thyroid too, who knows).

[AKatieD in reply to Incoguto]

Yes that is the reason for my initial question as it is also supposed to lower CBG and my free cortisol is high and bound is lower, so I was wondering if it was the testosterone making me feel rough. I had 2 days off T then restarted at smaller blob today and think I am worse again today (altho it could just be work, lol)!

[Incoguto in reply to AKatieD]

Yeah, there are studies that show T increases cortisol. Makes sense. My friend told me just now that T can cause thyroid resistance, but I'm waiting for more info!This is a minefield honestly.

[AKatieD in reply to Incoguto]

Agree, please let me know if you get any further. Meanwhile I am going to stop T cream for a week while I wait for DHEA supplement from the states in case it is combination of increased T and low DHEA that is causing problems via binding

[Incoguto in reply to AKatieD]

Yeah good idea. And one more thing to consider, excess T converts to E.

[AKatieD in reply to Incoguto]

Yes the O/ E had also gone up to 398nmol/L but was not expecting this to cause a problem either due to high SHBG. Consultant thought both fine. This was gynae consultant but as we know from thyroid experiences with endos, they are often not a good guide ..... I do have to pay for consultant for HRT as can' t self source like for thyroid ( as far as I know).

[Incoguto in reply to AKatieD]

So it seems some T is converting to E.Sure, my gyno thinks my free T could be at top range or slightly over....I don't know if I should have been prescribed T for midrange free T and over midrange total T!

I wonder if I may just test Free testosterone now and if high, take it every other day

[AKatieD in reply to Incoguto]

Has it done what you were hoping for albeit made other things worse?

[Incoguto in reply to AKatieD]

Nope, I am not sure I'm feeling anything positive, I'm skin is oily, I'm sweating, but that could be thyroid. My best bet is probably to test TMy estradiol and prog were high in ranges, while T was mid.

[AKatieD in reply to Incoguto]

If not any benefit and levels were not low anyway, probably not worth the effort for now. Can always keep under review. I am 20 years older so everything was low - you may get there in the end

[Incoguto in reply to AKatieD]

Yeah so far I am not noticing much. Maybe I'm calmer. Do you think it is worth checking the level before discontinuing?I'm sure I'll get there in the end 😀 but first I need to survive this.

Is your skin oily on this level?

[AKatieD in reply to Incoguto]

Not oily skin, i spent my whole life it seemed before menopause with that, maybe the odd spot that I have not had for a while now. But that is probably as skin much older than yours.

I think for you I would think it depends how desperate you are feeling in terms of needing to be better. I am struggling to concentrate at work ( brain job) and not patient at the best of times, so always want to fix asap. If you can wait and afford it, test everything first - sex hormones, thyroid, dhea, cortisol ( saliva and 8am blood) and usual vits etc recommended here and decide from there.

The Androfeme T info says it should be out of our system in a few days, so I plan to stop for a week and see if that fixes it. Add in the DHEA which was low, see what that does - maybe starting from better foundation - then increase up to smaller dosethan currently. See how I get on as it definitely helped my feeling of wellbeing, strength and especially breathing as I mentioned initially. (I did not take for libido but as far as I can tell ( widowed) no effect there.)

[Incoguto in reply to AKatieD]

I am desperate enough, I am not able to work, my savings are getting depleted, I am in a relationship with this wonderful man and suppose to move to US next year. I have tested all above. My dheas is above midrange, so are estradiol and progesterone, cortisol saliva and blood fine mostly (they respond to thyroid dose changes a lot). Vits all optimal, even had iron IV.

That's a good idea for sure. Maybe you just need smaller T doses once you restart if you decide to do so? You know your t3 would bump up your T levels too? Or at least they should in theory.

[AKatieD in reply to Incoguto]

If everything else checked and Ok, I would try dropping the T first and see what that does. Then if no better would try the T3 switch and see about that. If not those, I would get a general heath check to make sure nothing else going on. Best of luck

[Incoguto in reply to AKatieD]

I'll do a free T test tomorrow or Wed, then see what it says. General health check was already done, including an MRI.

Splitting the dose made me worse in many ways.

Thank you! Best of luck to you too.

[Incoguto in reply to AKatieD]

Is the Androfeme you take 5 or 10mg per day? I take 2mg per day and see that some women take even less than that. We produce 1mg per day naturally. That's my understanding.

Might make sense to stop yours and halve it maybe based on your results?

[AKatieD in reply to Incoguto]

5mg I think

[BB001]

My NHS GP has prescribed Prasterone (DHEA) for low libido. This is the only reason NHS prescribed DHEA.

[AKatieD]

Yes, that is typical NHS, they only prescribe testosterone for that too when it has a much wider range of action.